Surgeons at work. Aga khan Hospital surgeons will on Thursday use Video Conference Surgery (VCS) technology to operate on patients under the guidance of specialists sitting in India, saving on costs associated with quality treatment abroad such as air tickets and accommodation. Liz Muthoni (Nairobi)

By Mugambi Mutegi (email the author)

Posted Wednesday, September 7 2011 at 20:35

The first surgery enabled by remote video technology in Kenya will be performed on Thursday at the Aga Khan University Hospital.

The Nairobi-based surgeons will use Video Conference Surgery (VCS) technology to operate on patients under the guidance of specialists sitting in India, saving on costs associated with quality treatment abroad such as air tickets and accommodation. (READ: Pain of treatment deepens with rise in medical fees )

Doctors said the technology could significantly reduce the cost of specialised treatment and enhance Kenya’s status as a medical tourism destination.

“This mode of treatment is being used in many developed countries since it obviates the need for doctors traversing continents to offer treatment,” said Jose Banda, the executive director of the Kenya Kidney and Lupus Foundation.

VCS allows surgeons to oversee operations either through controlling robotic machines or by teleconference liaison with supervising doctors in the operating room.

Internet provider Access Kenya and Asterisk and Sight & Sound will be providing the broadband service.

VCS procedures are highly dependent on a reliable and high capacity bandwidth because precision is key to the success of any operation. Besides giving patients access to faster treatment, the technology will help claw back on revenue that was previously going abroad.

“Furthermore patients can access up-to-date treatment from particular specialists lacking in their country and therefore enjoy better recuperation without the hassles of boarding aeroplanes,” Mrs Banda.

The number of patients seeking surgery in India, for instance, is expected to reach 50,000 this year compared to half that number last year.

Some of the most common ailments that have for years precipitated an exodus of patients to Asia and Europe include neurological disorders, brain surgery, open heart surgeries and orthopedic-related ailments.

Recent data indicates that Kenya requires 24,000 doctors but only has 7,000, with 3,000 of them working in public hospitals and 4,000 in private ones. Brain drain has taken another 1,000 to greener pastures abroad.

The capacity gap to meet the demand for services has seen many seek treatment abroad, their choice dictated by waiting lists, some of which stretch several months before surgery can be performed.

“We have for years referred our patients to other countries for critical operations because the doctors there have been practising the procedures for much longer than our own,” said Mr Peter Nduati, the chief executive of Resolution Health East Africa, a medical insurer.

It is now common to get invited to fundraisers of relatives or friends collecting money to send their ailing patients abroad with the cost of the treatment running into millions of shillings.

Mr Nduati, however, cautions that the cost of having procedures done in local hospitals which embrace the technology needs to be low enough for VCS to have an impact.

“Hospitals embracing this technology should keep the charges affordable to stop the exodus especially to India where the cost is ten times less than in Kenya for some ailments,” he said.

VCS comes a month after the Aga Khan University Hospital unveiled a Sh4.25 billion heart and cancer centre meant to tap into the number of patients from Kenya and the region who travel abroad for treatment.

Top hospitals in the country have in the past four months increased their charges by up to 40 per cent leaving medical insurance providers contemplating to effect premium changes to reverse underwriting losses.

Remote provision of healthcare is gaining pace in the country with mobile providers Safaricom and Telkom Kenya said to be exploring different innovations.

Health Presence, being fronted by Safaricom, is expected to be situated at the digital villages it is currently building from where patients will consult their doctors through teleconferencing.

Kenya Thursday reached a medical milestone by having the first surgery enabled via video links successfully concluded at the Aga Khan University Hospital in Nairobi. Video Conference Surgery, as the innovation is known, offers limitless opportunities for procedures that Kenyans have been shopping for abroad, largely because of the high costs of the treatment locally and, in some cases, because of the waiting lines at public facilities with the capacity to perform the operations more affordably.

Besides the direct benefits to patients, there is the long term aspect of linking doctors in Kenya, with more experienced and skilled medics in countries dictating instructions to their local counterparts. These will form the next knowledge pool that Kenya can rely on for training of future doctors, hopefully helping reduce the personnel deficit that has left only 7,000 doctors serving in Kenya compared to a demand of 24,000.

VCS also promises better linkages between doctors in hospitals in remote areas and specialists in leading private and referral hospitals that would help perform delicate procedures without patients having to be transferred. Infrastructure challenges, however, limit the potential to which telemedicine can be practised in Kenya, outside the main urban centres. For one, the technology requires a dependable bandwidth in a sector where precision is, literally a matter of life and death. This calls for the government to expedite laying out of the fibre optic cables to major centres in Kenya.

The bandwidth aside, there is the need for supporting infrastructure such as electricity, which for now is not installed in remote outposts. However, it is in creating public awareness that the most arduous task lies. Some medical practitioners are already downplaying the significance of VCS possibly because it threatens potential revenue streams and for reasons of business rivalry.

Such sentiments are nevertheless likely to discourage potential users of the technology because of fears over the risks inherent in the mode of treatment. Once these challenges are addressed Kenya will be swiftly on the way to becoming a medical tourism hub in Africa.

This will have a great bearing on the country’s balance of trade and, at a human scale, alleviate the plight of thousands of families that watch helplessly as their loved one suffer for years from treatable neurological disorders, brain, heart and orthopedic ailments just because of want of financial resources

The Department of Pharmacy Services, Aga Khan University Hospital has won the Asian Hospital Management Awards 2011 in Singapore. The winning project was entitled: “Enhancing patient safety through innovations in the Computerised Physician Order Entry (CPOE) system”. The award was received by Abdul Latif Sheikh, Director Pharmacy, at a grand ceremony held in Singapore on September 8, 2011.

A total of 315 entries representing 84 hospitals from 11 countries were submitted of which the 35 finalists represented 24 hospitals from 9 countries.

Awards are given to those hospitals in the region that, in the opinion of the judges and advisers, have implemented or enhanced outstanding and innovative projects, programs, and best practices. The awards program recognizes and honours hospitals in Asia that carry out best hospital practices.

The Hospital Management Asia is organised in cooperation with Joint Commission International, Johns Hopkins Medicine International, International Hospital Federation and the Asian Hospital Federation, with the support of the Singapore Ministry of Health.

This achievement has been made possible by the quality and committed leadership, teamwork, effective contribution of pharmacy staff, P&T committee, I.T. and other key players of medication management i.e., nursing as well as physicians.

AKU gives details about its efforts to help the flood-affected population after last year’s floods and rain disaster this year

KARACHI - The Aga Khan University (AKU) has calculated that its teams have treated over one million patients in the flood-hit areas of Sindh and Balochistan since the disaster struck these areas in 2010. In a press released issued on Wednesday, AKU said that it responded to the national disaster by dispatching medical teams as soon as possible to Khairpur and Sukkur in Sindh, followed by Jaffarabad in Balochistan.
Later, the AKU sent out several teams of its volunteers, doctors and nurses, who provided urgent health services through camps, mobile units and government-run basic health units and hospitals. At the university, a range of departments supported these efforts, providing people with medical supplies, food, transport and security. Eventually, 16 districts across Sindh, southern Punjab and Balochistan were covered.
The AKU’s Flood Response Programme has been generously supported through a $6.2 million grant from the US Agency for International Development (USAID) as well as a contribution of a day’s salary by the university’s faculty and staff. Besides volunteers, over 300 full-time contractual staff of the AKU has provided healthcare to the flood-affected people in these districts. Over one million people have received lifesaving health care from AKU as a result of the programme.
The flood-affected people received treatment for dehydration, diarrhoea, pneumonia, snake bites, skin infections and many other diseases associated with the floods. Nurses and doctors also provided antenatal care, assisted deliveries and administered vaccinations.
In addition to basic healthcare, the programme also includes a nutrition intervention component, treating malnourished and under-nourished children with ready-to-use therapeutic food and micronutrients, and women of reproductive age with folic acid and iron supplementation. One of the biggest strengths of the AKU’s programme has been the low cost of about $3 per patient, enabling the university to treat more people.
“The Aga Khan University is a strong example of the numerous local organisations that have worked with USAID to alleviate human suffering caused by the floods,” said USAID Mission Director Andrew Sisson. “The United States is committed to supporting the Pakistani government and people in their efforts to address Pakistan’s priority issues.”
Over the past weeks, medical care has been provided to the communities in Sindh, in Badin and Khairpur, most affected by this year’s floods, reaffirming AKU and USAID’s resolve to help those who are most affected by the disaster.

National Nutrition Survey 2011: Food insecurity affecting 60% of women and children
By Sehrish Wasif
Published: September 18, 2011

ISLAMABAD:

Around 60% of Pakistan’s total population is facing food insecurity, revealed Pakistan’s National Nutrition Survey (NNS) 2011 on Saturday. The results of the survey, termed by health experts as “alarming”, indicate a significant decline in the nutritional status of the people of the country over the past decade.

This information was disclosed at the launching ceremony of NNS 2011 held here at a local hotel. The national survey, conducted by Ministry of Health’s (MoH) Nutrition Wing in collaboration with Agha Khan University (AKU), assessed the nutritional status of the population, especially women and children, while also covering morbidity and family care practices.

Dr Greg Moran brings over two decades of experience as member of University of Western Ontario faculty, researcher and theses supervisor

KARACHI - Dr Greg Moran has been appointed as the new provost of the Aga Khan University (AKU) and the chief academic officer will play a key part in overseeing the quality of the entire university’s academic programmes. According to a statement issued by the AKU Public Affairs, Dr Moran brings over two decades of experience as faculty, researcher and theses supervisor.A member of the faculty of the University of Western Ontario (UWO) in London, Ontario, Canada since 1977, he has been a full-time professor since 1992 besides holding a number of administrative positions. These have included chair of the department of psychology, dean of graduate studies, provost, vice president (academic), and twice, he was acting president.

KARACHI: ‘The delay in diagnosis of visual impairment lead to blindness while 80 percent of people with cataracts, glaucoma, age-related macular degeneration and diabetes-related blindness can be avoided or cured through timely diagnosis and proper treatment.’

Health experts stated this at a seminar held at the Aga Khan University Hospital (AKUH) to mark the World Sight Day on Thursday.

The eye specialists said cataract remains one of the principal causes of blindness for all age groups even though they are more common in older people in developing countries.

She said a simple eye examination could help diagnose the disease, which is initially treated through glasses, brighter lighting and magnifying lenses while reading. However, when these do not help, surgery can resolve the problem – a short outpatient procedure where the natural lens is replaced with an artificial one. This treatment is widely available in the country, she added.

Highlighting the paediatric eye problems, Consultant Ophthalmologist and head of Ophthalmology Section at AKUH Dr Tanveer Chaudhry explained that in children a squint might be a symptom of something more serious and should not be ignored.

He also laid emphasis on the need for premature babies to be screened promptly for eye problems. Retinopathy of prematurity is a potentially blinding eye disorder that affects premature infants, he informed.

“At AKUH, we have a referral system for the screening of such children but we need to increase awareness among all health care providers and general public so the sight of children born early can be saved,” he says.

He maintained that a recent survey of leading maternity homes and hospitals across Karachi, well equipped to save very premature children, showed a lack of awareness of ROP and its management.

Consultant Ophthalmolo-gist, AKUH Dr Rashid Baig said globally, glaucoma is another major cause of blindness. High pressure within the eye is thought to be one of the reasons for this group of diseases that lead to gradual vision loss. Sometimes, though, glaucoma may arise unexpectedly with a sudden onset of headaches, blurred vision and pain in the affected eye. He noted that although there was no cure for glaucoma, early diagnosis, regular eye exams and treatment could control the progression of the disease.

The Aga Khan University, an international multi-site higher education institution, has launched a new drive to lure East Africans studying abroad back home. It hopes the opening of a new state-of-the-art campus in Arusha, northern Tanzania, will bring back to the region thousands of students from Tanzania, Kenya, Uganda, Rwanda and Burundi, who fly out of East Africa in droves every year in search of better education in the US, Europe and Asia.

Aga Khan University already has three campuses in Tanzania, which specialise in teaching nursing, medicine and education, and located in the country’s commercial capital Dar es Salaam. The new campus is set to house arts and science faculties and educate up to 3,000 students from across East Africa.

Heart beat: 7% to 20% of people do not survive a stroke
Published: October 27, 2011

KARACHI: Nearly 400 people in the country die because of strokes everyday yet people, especially those in the media do not take it seriously, said Society of Neurology Pakistan Secretary and Aga Khan University Hospital Associate Professor Dr Mohammad Wasay.

“Since there is no awareness about the symptoms, people do not bother going to the hospital immediately.”

While speaking at the Karachi Press Club on Wednesday, Dr Wasay said that there was a need to create awareness especially since it affected nearly 350,000 people in Pakistan. “A stroke can be prevented and can be treated with proper medication,” he said. “It is our duty to protect people from them and to create awareness so that the government can take measures against it.” He added that a stroke could easily be avoided by exercising, controlling the intake of salt and not smoking. “The ratio of strokes in men is higher as compared to women,” he said.

Dr Abdul Malik from the Jinnah Postgraduate Medical Centre said that everyday nearly 22 per cent of patients had a stroke and only seven to 20 per cent did not survive. He added that the Pakistan Stroke Society was organising an event on World Stroke Day to educate people. They also plan to hold two free stroke camps to check cholesterol and blood pressure.

*****
Young minds: AKU-EB awards higher achievers all over the country
Published: October 27, 2011

KARACHI: Dressed formally in crisp school uniforms, students from different schools had gathered at the Aga Khan University Hospital (AKUH) auditorium to receive their higher achiever awards on Wednesday.

The AKU-Education Board had held its annual award ceremony for the Secondary School Certificate (SSC) and the Higher Secondary School Certificate (HSSC). Pop singer and Zindagi Trust Foundation founder Shehzad Roy was present as chief guest. The ceremony kicked off with a brief introduction about the higher achievers and the boards accomplishments. According to Roy, the young people were the leaders of tomorrow. “If we want our young people to conquer the world and contribute to society, then it is essential for us to provide them with good education,” he said. “A decade or two from now this country is going to witness a great change because our students will be equipped with knowledge and skills to use it effectively.” He added that the AKU-EB has set an example in providing high quality education in the country. They started distributing the award certificates with Roy singing one of his all time hits, ‘Tera kangna jab khankay.’

AKU-EB Director Dr Thomas Christie gave out the SSC certificates to students from all over Pakistan. Roy was called up on stage again to give out awards certificates to HSSC students. AKUH President Faiz Rasul was asked to come on stage and give the certificates to Hooria Imran, Komal Zehra Zaidi and Sarah Salahuddin, the top three SSC students and Hani Ghulam Abbas, Asma Gulab and Raaza Malja, the top three HSSC students.

Pre-engineering student Hani Ghulam Abbas and pre-medical student Asma Gulab told The Express Tribune that it was impossible to pass the exam until and unless you understand the subject completely. This year, the AKU-EB has awarded 180 distinctions in different subjects and groups to students from 23 cities. Certificates and cash prizes were also distributed to the top three SSC and HSSC position holders.

Towards the end of the ceremony, Dr Christie said that in the last 10 years, the media had revolutionised and in future the AKU-EB would start media studies and journalism programmes.

The Aga Khan University (AKU) auditorium was a swirl of green and white convocation robes on Saturday as the class of 2011 prepared to take its final walk as students.

The 317 degrees had to be conferred upon students in two separate ceremonies for the Medical College and Institute for Educational Development and the School of Nursing. Four of the students walked away with doctorates – one in education and three in the health sciences.

The students trooped into the hall carrying a flag bearing the university emblem. The chief guest, president, registrar and faculty followed in their wake and Board of Trustees Chairman Ambassador Saidullah Khan Dehalvi opened the celebrations.

“Not only has AKU broken new ground in the delivery of health care and education,” said Afghanistan Acting Public Health Minister Dr Suraya Dalil, as she addressed the gathering as the chief guest, “but by combining education and health delivery it has built a synergy that has mutually reinforced both disciplines.” Dr Dalil pointed out that six of the graduates were Afghans.

In the afternoon, the 149 School of Nursing graduates filled the auditorium. AKU President Firoz Rasul emphasised the university’s efforts towards producing competent professionals with the ability to solve problems.

The graduates, young and old, were filled with a sense of accomplishment and fulfilment. Syed Javed Mehdi, a fresh Master’s in Education, is actually a grade 16 government school teacher and teaches secondary classes. His frail mother stood beside him, swathed in a black shawl but beaming with pride over her youngest son’s achievement. She had come all the way from Khairpur to see him graduate. Syed feels he learnt how to innovate and bring about change in the educational system during his time at AKU.

The PhDs, meanwhile, are exploring new research in the country. Dr Mohsin Yaqoob flew back from Johns Hopkins University to attend his convocation. He completed his doctorate in Physiology and was offered a post doctorate from Hopkins, but he definitely intends to come back to Pakistan. He said that while getting into AKU was difficult, it was not at all unaffordable.

“AKU first selects students on merit and later the fee details are [worked out],” he explained. “In case he or she cannot afford it, it is paid by the university.” This is what makes the PhD programme highly competitive and only about four of almost 90 applications are selected, he explained.

Dr Junaid Iqbal, another new PhD holder, received a 100 per cent scholarship at AKU. He was inspired by a personal incident to take up astrobiology and is researching extremophiles, parasites – a subject alien to Pakistan. Similarly, their colleague, Dr Humera Humayan is off to Japan for her post graduation after completing a PhD in Microbiology.

Raising the MBBS bar

For the MBBS students, expectations are high. Of the 95 graduates, 15 are already Medical Diplomats that licences them to work in the US after they pass their USMLE.

Standing in queue for their graduate pictures beside the university emblem, Akbar Saleh, Umar Rasheed and Umar Tariq said that they have already received calls for residencies from the US. The competitive school has driven them to be the best they can and thus most of them aim to leave the country.

Their classmate, Fatima Sadiq, wants to leave for a year-long internship followed by a residency in the US while Asif Jafferani, the best graduate, wants to specialise in cardiac electrophysiology. While there are four to five cardiac electrophysiologists in the country, training in the field is not taught in Pakistan and he would like to bring the study to students here.

Nursing is no joke

“A lot of parents think that entering nursing is the end of their child’s future but it is not so,” AKU School of Nursing Dean Dr Rozina Karam Alani told The Express Tribune.

She explained that while more and more students are opting to become nurses, the profession still suffers because of its image and its low pay. While the government has raised doctor salaries, nurses make the same amount. Meanwhile, doctors can make more money through private practices while nurses cannot.

“It cost me up to Rs30,000, including fees, accommodation and other expenses during my education,” complained Kashif, a graduate originally from Sialkot. “While when I graduate the pay is hardly Rs20,000.”

There is scope for further education and growth in nursing, however. Students can complete Masters, PhDs, and research. As far as competition is concerned, she said that Dow University of Health Sciences, Baqai, Ziauddin, and Jinnah Postgraduate Medical Centre are all producing very competent professionals. However, there are about 50 alumni from AKUSON in top positions in the country, she boasted.

Zara Rafiq, who received the best graduate award in nursing, said that she sees the profession in conformity to what her religion preaches – to serve the community.

Published in The Express Tribune, November 13th, 2011.
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